CEFTRIAXONE - A PHARMACOECONOMIC EVALUATION OF ITS USE IN THE TREATMENT OF SERIOUS INFECTIONS

Ceftriaxone possesses a broad spectrum of antimicrobial activity that includes the Gram-positive and Gram-negative aerobes commonly associat ed with serious infections. Its therapeutic efficacy is comparable to that of other third-generation cephalosporins and aminoglycoside-combi nation regimens. The most commonly reported adverse events with ceftri axone are similar in incidence and severity to those reported with oth er third-generation cephalosporins. Notably, the drug has a favourable pharmacokinetic profile which allows once-daily administration. In co mparative studies with other parenteral regimens requiring 3 to 6 dail y doses, treatment with once-daily ceftriaxone reduced total antimicro bial drug costs (i.e. acquisition, preparation and administration cost s) by 17 to 52%. Ceftriaxone was also more cost effective than ceftazi dime and a variety of other antimicrobial treatment regimens (penicill ins, cephalosporins, combination regimens) in the treatment of patient s with community-acquired pneumonia or bronchopneumonia. This reflecte d lower drug and hospitalisation costs associated with a reduced lengt h of hospital stay in ceftriaxone recipients. In noncomparative studie s, ceftriaxone achieved considerable hospitalisation cost savings in p atients with serious infections (mostly bone, joint, skin/skin structu re infections), who were able to receive all or part of their antimicr obial therapy as outpatients. In one analysis which evaluated all dire ct and indirect costs (such as training programmes, transportation, ti me for visits and supplies) and benefits (such as hospitalisation cost savings, return to work or school, increased productivity) of outpati ent ceftriaxone therapy, the overall benefit-cost ratio was approximat ely 5 : 1. The studies to date confirm that ceftriaxone is effective, well tolerated, convenient to administer and, when utilised appropriat ely, offers the potential for cost avoidance in patients with serious infections. Although additional well designed pharmacoeconomic analyse s are needed to further evaluate its cost effectiveness, ceftriaxone s hould be considered an essential third-generation cephalosporin formul ary representative in most clinical settings.